Rocky Ford Snow Removal Program-2019/2020 Application
Hello! Thank you for your interest in the Rocky Ford Snow Removal program.

By completing this form, you agree to share your address & phone number with Small Town Project, who will then share it with a volunteer(s), who will assist you with shoveling snow during the 2019/2020 winter season. This program is implemented by the Small Town Project.

Applications will be reviewed and you will receive a decision within 2-3 business days.
Sign in to Google to save your progress. Learn more
Email *
What is your First and Last Name *
What is your Phone Number *
Can we send text messages to this number? *
What is your address? *
Tell us about your property *
Month and Year of Birth *
By clicking "Verified", I verify that I am home-bound and/or disabled, and/or sixty years old or older, and that my total household income is at or below $20,358. I understand that if I give false information or withhold information I could be prohibited from using this program. *
We would like to better understand the needs in our community. Please let us know if you have any additional needs for volunteer assistance throughout the year.
If you have any questions you can contact Duane Gurule, Communications Director for Small Town Project by email at dgurule@smalltownproject.org or by phone at (720) 746-8949.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Small Town Project. Report Abuse